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Cryptogenic stroke and migraine: using probabilistic independence and machine learning to uncover latent sources of disease from the electronic health record

Betts, Joshua W., Still, John M., Lasko, Thomas A.

arXiv.org Artificial Intelligence

Migraine is a common but complex neurological disorder that doubles the lifetime risk of cryptogenic stroke (CS). However, this relationship remains poorly characterized, and few clinical guidelines exist to reduce this associated risk. We therefore propose a data-driven approach to extract probabilistically-independent sources from electronic health record (EHR) data and create a 10-year risk-predictive model for CS in migraine patients. These sources represent external latent variables acting on the causal graph constructed from the EHR data and approximate root causes of CS in our population. A random forest model trained on patient expressions of these sources demonstrated good accuracy (ROC 0.771) and identified the top 10 most predictive sources of CS in migraine patients. These sources revealed that pharmacologic interventions were the most important factor in minimizing CS risk in our population and identified a factor related to allergic rhinitis as a potential causative source of CS in migraine patients.


Predicting Postoperative Stroke in Elderly SICU Patients: An Interpretable Machine Learning Model Using MIMIC Data

Li, Tinghuan, Chen, Shuheng, Fan, Junyi, Pishgar, Elham, Alaei, Kamiar, Placencia, Greg, Pishgar, Maryam

arXiv.org Artificial Intelligence

Postoperative stroke remains a critical complication in elderly surgical intensive care unit (SICU) patients, contributing to prolonged hospitalization, elevated healthcare costs, and increased mortality. Accurate early risk stratification is essential to enable timely intervention and improve clinical outcomes. We constructed a combined cohort of 19,085 elderly SICU admissions from the MIMIC-III and MIMIC-IV databases and developed an interpretable machine learning (ML) framework to predict in-hospital stroke using clinical data from the first 24 hours of Intensive Care Unit (ICU) stay. The preprocessing pipeline included removal of high-missingness features, iterative Singular Value Decomposition (SVD) imputation, z-score normalization, one-hot encoding, and class imbalance correction via the Adaptive Synthetic Sampling (ADASYN) algorithm. A two-stage feature selection process-combining Recursive Feature Elimination with Cross-Validation (RFECV) and SHapley Additive exPlanations (SHAP)-reduced the initial 80 variables to 20 clinically informative predictors. Among eight ML models evaluated, CatBoost achieved the best performance with an AUROC of 0.8868 (95% CI: 0.8802--0.8937). SHAP analysis and ablation studies identified prior cerebrovascular disease, serum creatinine, and systolic blood pressure as the most influential risk factors. Our results highlight the potential of interpretable ML approaches to support early detection of postoperative stroke and inform decision-making in perioperative critical care.


Machine Learning-Based Model for Postoperative Stroke Prediction in Coronary Artery Disease

Pan, Haonan, Chen, Shuheng, Pishgar, Elham, Alaei, Kamiar, Placencia, Greg, Pishgar, Maryam

arXiv.org Artificial Intelligence

Coronary artery disease remains one of the leading causes of mortality globally. Despite advances in revascularization treatments like PCI and CABG, postoperative stroke is inevitable. This study aims to develop and evaluate a sophisticated machine learning prediction model to assess postoperative stroke risk in coronary revascularization patients.This research employed data from the MIMIC-IV database, consisting of a cohort of 7023 individuals. Study data included clinical, laboratory, and comorbidity variables. To reduce multicollinearity, variables with over 30% missing values and features with a correlation coefficient larger than 0.9 were deleted. The dataset has 70% training and 30% test. The Random Forest technique interpolated residual dataset missing values. Numerical values were normalized, whereas categorical variables were one-hot encoded. LASSO regularization selected features, and grid search found model hyperparameters. Finally, Logistic Regression, XGBoost, SVM, and CatBoost were employed for predictive modeling, and SHAP analysis assessed stroke risk for each variable. AUC of 0.855 (0.829-0.878) showed that SVM model outperformed logistic regression and CatBoost models in prior research. SHAP research showed that the Charlson Comorbidity Index (CCI), diabetes, chronic kidney disease, and heart failure are significant prognostic factors for postoperative stroke. This study shows that improved machine learning reduces overfitting and improves model predictive accuracy. Models using the CCI alone cannot predict postoperative stroke risk as accurately as those using independent comorbidity variables. The suggested technique provides a more thorough and individualized risk assessment by encompassing a wider range of clinically relevant characteristics, making it a better reference for preoperative risk assessments and targeted intervention.


Machine learning algorithms to predict stroke in China based on causal inference of time series analysis

Zheng, Qizhi, Zhao, Ayang, Wang, Xinzhu, Bai, Yanhong, Wang, Zikun, Wang, Xiuying, Zeng, Xianzhang, Dong, Guanghui

arXiv.org Machine Learning

Participants: This study employed a combination of Vector Autoregression (VAR) model and Graph Neural Networks (GNN) to systematically construct dynamic causal inference. Multiple classic classification algorithms were compared, including Random Forest, Logistic Regression, XGBoost, Support Vector Machine (SVM), K-Nearest Neighbor (KNN), Gradient Boosting, and Multi Layer Perceptron (MLP). The SMOTE algorithm was used to undersample a small number of samples and employed Stratified K-fold Cross Validation. Results: This study included a total of 11,789 participants, including 6,334 females (53.73%) and 5,455 males (46.27%), with an average age of 65 years. Introduction of dynamic causal inference features has significantly improved the performance of almost all models. The area under the ROC curve of each model ranged from 0.78 to 0.83, indicating significant difference (P < 0.01). Among all the models, the Gradient Boosting model demonstrated the highest performance and stability. Model explanation and feature importance analysis generated model interpretation that illustrated significant contributors associated with risks of stroke. Conclusions and Relevance: This study proposes a stroke risk prediction method that combines dynamic causal inference with machine learning models, significantly improving prediction accuracy and revealing key health factors that affect stroke. The research results indicate that dynamic causal inference features have important value in predicting stroke risk, especially in capturing the impact of changes in health status over time on stroke risk. By further optimizing the model and introducing more variables, this study provides theoretical basis and practical guidance for future stroke prevention and intervention strategies.


Stroke Prediction using Clinical and Social Features in Machine Learning

Chadha, Aidan

arXiv.org Artificial Intelligence

Every year in the United States, 800,000 individuals suffer a stroke - one person every 40 seconds, with a death occurring every four minutes. While individual factors vary, certain predictors are more prevalent in determining stroke risk. As strokes are the second leading cause of death and disability worldwide, predicting stroke likelihood based on lifestyle factors is crucial. Showing individuals their stroke risk could motivate lifestyle changes, and machine learning offers solutions to this prediction challenge. Neural networks excel at predicting outcomes based on training features like lifestyle factors, however, they're not the only option. Logistic regression models can also effectively compute the likelihood of binary outcomes based on independent variables, making them well-suited for stroke prediction. This analysis will compare both neural networks (dense and convolutional) and logistic regression models for stroke prediction, examining their pros, cons, and differences to develop the most effective predictor that minimizes false negatives.


Researchers find AI can predict new atrial fibrillation, stroke risk

#artificialintelligence

A team of scientists from Geisinger and Tempus have found that artificial intelligence can predict risk of new atrial fibrillation (AF) and AF-related stroke. Atrial fibrillation is the most common cardiac arrhythmia and is associated with numerous health risks, including stroke and death. The study, published in Circulation, used electrical signals from the heart--measured from a 12-lead electrocardiogram (ECG)--to identify patients who are likely to develop AF, including those at risk for AF-related stroke. "Each year, over 300 million ECGs are performed in the U.S. to identify cardiac abnormalities within an episode of care. However, these tests cannot generally detect future potential for negative events like atrial fibrillation or stroke," said Joel Dudley, chief scientific officer at Tempus.